I have been working with a client for some time now, whose aphasia remains a mystery to me.I have spiraled through several postulated models of neuropathology, trying to find the road in, so he can find his road out.This is always based on whatever he can show me about his language and speech processes, which are perhaps the most complicated I have ever known.

We’ve been together two years now.The man is exceedingly patient with my intellectual and academic pursuits of his demons.I share with him my thoughts, and he tells me what he thinks about what I think about what his brain is doing.

It’s like a neuropsychological party line.We are listening to all the voices, and trying to understand what is being said.

I have come to respect his brain, to truly appreciate its struggles to find what I imagine to be compensatory and wayward tracks up, over, or through brick walls that impede access to the modalities we call speech, comprehension, reading and writing.His brain is teaching me things all the time.Having puzzled a rational solution to one tiny piece of behavior, it defies me and goes the other way, or in a random arc somewhere I cannot follow.

Of course, I’ve had a trick or two myself. Sometimes we are speaking only to each other, and I know the brain is listening.Other times, it’s that three-way conversation.I resist images of the brain in a corner, laughing while we other two try to bend it to our wills.This is not a teasing, adolescent brain, although it may be ornery, for sure.This brain deserves respect and reverence for the amazing job it is doing.

If McNamara is right, this man’s brain may indeed go where it is most appreciated, back in line with the heart, which knows exactly where it wants to be, and maybe, how to get there.